"They were never going to do the heavy lifting ... and they just proved it."
Obamacare and Abortion
In his September 2009 speech to Congress, the President pledged that “[u]nder our plan, no federal dollars will be used to fund abortions.” Ultimately, however, the bill signed into law by the President in March 2010 fell short of providing a full set of pro-life protections. Obamacare sets a new precedent by providing federal funding to plans that cover abortion. In addition, government auditors found that the supposed safeguards included in the law—insufficient to protect against the scenario the President alleged would not take place—have not been properly implemented or enforced.
Hyde Amendment Protections
Enacted every year since 1976, the Hyde amendment, named for former Congressman Henry Hyde (R-IL), prohibits federal funding of elective abortions, with exceptions in the cases of rape, incest, or to save the life of the mother. In general, the Hyde Amendment has worked well in preventing taxpayer funding of abortion in programs like Medicare and Medicaid; in these programs, government directly funds the services, and therefore can specifically prohibit coverage of a particular service.
...the segregation scheme does not disguise the fact that ultimately, money is fungible, and taxpayer-funded insurance subsidies will make this “supplemental” abortion coverage more affordable, thereby subsidizing abortions.
By providing health coverage through private insurance plans, however, Obamacare creates a unique dilemma. Unless coverage provided by a third-party insurance company explicitly excludes abortions, any federal funds subsidizing that policy will by definition also subsidize abortion procedures—by making a health plan that covers abortion more affordable. For this reason, the privately-run insurance plans in the Federal Employees Health Benefits Program (FEHBP) have been prohibited from covering elective abortions in any of their plans under long-standing practice.
Obamacare, however, chose a different route. Instead, the law created a segregation scheme, allegedly creating separate accounts, and separate payments, to cover the portion of plan costs related to abortion coverage. As noted above, however, the segregation scheme does not disguise the fact that ultimately, money is fungible, and taxpayer-funded insurance subsidies will make this “supplemental” abortion coverage more affordable, thereby subsidizing abortions.
Obamacare did allow states to prohibit elective abortion coverage in the state-based Exchanges created by the law. As of 2015, half (25) of states had imposed such restrictions, including ten that prohibit coverage of abortion in all private insurance plans. However, a separate section of the law creates a new multi-state insurance plan, and explicitly requires the federal Office of Personnel Management (OPM) to offer a plan that covers elective abortions in all 50 states, thereby erasing whatever moral autonomy states may have had under the tyranny of the law’s centralized power structure.
Rules Not Enforced
A September 2014 Government Accountability Office (GAO) report raised further concerns about implementation of the abortion provisions in Obamacare. Specifically, the GAO found:
- In five states in 2014, all plans offered on state Exchanges covered elective abortions—meaning that individuals who did not wish to purchase a policy that offers abortion coverage had no ability to do so;
- Nearly half of plans offered nationwide in 2014 covered elective abortions (1,036 did, while 1,062 did not);
- In a sample surveyed by GAO, most insurers that offer elective abortions placed no restrictions on coverage of the procedure;
- Most insurers in the sample did not comply with the requirement in the law to segregate funds and payments for abortion coverage; and
- Several insurers had not complied with a provision in the law requiring that a plan disclose to enrollees at the time of enrollment that it covered elective abortions—denying individuals who do not wish to purchase a policy covering abortions the opportunity to select another plan. In general, GAO generally found that the plans surveyed did not make it easy to discover plans’ policies regarding coverage of elective abortions when shopping for and comparing plans.
In general, the GAO findings suggested a lack of awareness, implementation, and enforcement of the provisions relating to abortion—all of which undermine the ability of individuals to assert their rights of conscience towards actions they find morally objectionable.
Other Concerning Provisions
Over and above questions regarding coverage of abortion procedures itself, Obamacare also includes a preventive services mandate that requires insurers to provide contraception coverage without cost-sharing. While the Supreme Court struck down the mandate for closely-held companies in the 2014 Hobby Lobby case, all Exchange plans still have to cover, and all individuals still have to buy, insurance policies that cover these contraceptives—including some drugs classified as abortifacients.
Finally, Planned Parenthood and its affiliates have received many grants to serve as Obamacare navigators and assisters. Planned Parenthood affiliates received several new Obamacare navigator grants in September 2015, even as Congressional committees continued to investigate a series of controversial videos that raise questions about Planned Parenthood’s activities regarding fetal tissue research. Some conservatives may be concerned about the increase in federal funding for the nation’s largest abortion provider as a result of this health care law.
Chris Jacobs is a Senior Editor at Conservative Review. Follow him on Twitter @chrisjacobshc.
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